By Nathan Tsukroff of PortraitEFX

Maine has wonderful doctors and great hospitals to treat almost any illness.

What it doesn’t have is an institute for cancer treatment in the center of the state. But that will start to change in early September.

The Dempsey Center in Lewiston, founded in 2008 by Patrick Dempsey as a way to give back to the community where he grew up, is committed to making life better for people managing the impact of cancer. However, it doesn’t provide the services of doctors for treating cancer.

That’s what a planned cancer center, or institute, at Central Maine Medical Center (CMMC) will provide for much of Maine, according to Dr. Sean McGarr, a gastroenterology doctor at the hospital. With a planned groundbreaking in early September, the cancer center will bring together cancer doctors – oncologists – from throughout the area to provide comprehensive cancer services.

“We have a wonderful Dempsey Center” which provides research, social support, and help for patients to navigate through the current healthcare system as they seek treatment for cancer, Dr. McGarr said, but, “It’s not a cancer center; it’s not a cancer institution.”

CMMC’s cancer center will have “a multi-disciplinary cancer institution,” where multiple healthcare providers who specialize in cancer can be found in one place, Dr. McGarr said.

Maine is a very large state with only one other cancer center, Maine General Medical Center’s Harold Alfond Center for Cancer Care in Augusta.

Dr. McGarr, who was a Director of Gastrointestinal Oncology at Maine General before coming to CMMC, looks to make the CMMC center a partner with doctors throughout central Maine, providing continuing care for patients close to their homes after their initial cancer treatments.

“Our mission has been to make it accessible,” he said. “A lot of our patients don’t live right around the block. To come from sites that are on the coast, or sites that are up in the mountains, to come to one place . . . the goal, I think would be to see all your doctors and limit the travel to make it as efficient of a visit as you possibly can get.”

With a multi-disciplinary team, “You have radiologists looking at the film, you have oncologists that have read the biopsies, you have the surgeons that are meeting with you and talking about the options . . . those folks that specialize in cancer care, all in one spot,” Dr. McGarr said.

“We’ve come together in an area that is more centrally-located,” Dr. McGarr said. “We’re becoming more accessible by having the right doctors, the right cancer folks in one institution,” so patients don’t have to travel from town to town find the doctors they need for their treatments. Keeping all the doctors “under one roof, working together” makes for a more cohesive team with better communication, he said. “It’s better for the patient!”

Dr. McGarr said he came to CMMC about 18 months ago because he liked the fact that CMMC was growing under its new leadership and was bringing in the doctors and the physicians that his patients needed from a gastroenterology standpoint. He is a Maine native from Orrington, and did his undergraduate studies at the University of Maine in Orono, followed by medical school at Western University of Health Sciences in Pomona, CA, and an internal medicine residency at Johns Hopkins University/Sinai Hospital in Baltimore, MD.

The cancer center will not take patients away from other practices or hospitals in Maine, Dr. McGarr said. “There’s a different patient population, there’s a different need. Unfortunately, we’re seeing only more pancreatic cancer. In Maine there’s a problem with alcohol, tobacco, obesity (which) unfortunately lends itself to a higher risk of cancer.”

Cancer patients often travel to Boston for treatment, Dr. McGarr said, and the long hours of travel along with the lack of easy follow-up care make that a difficult choice for patients. “As you get older, driving to Portland’s like driving to Boston! If you come from a couple of hours north . . . Boston becomes further and further away.”

“We’re bringing the talent and bringing these physicians into Lewiston. It’s the second-biggest city in the state, and it certainly should have a cancer center,” he said.

Dr. McGarr said it makes sense to open a cancer center in Lewiston. “I think patients are demanding it. I think patients are the ones kind of dictating how healthcare is going to go in the state of Maine. And I think that’s wonderful! There should be options for patients. And patients should be able to go to whom they want to see for a physician and know that that physician has some colleagues that they work with,” and the technology and facilities that help them provide the needed services. 

Along with Dr. McGarr, Dr. Lisa Rutstein, a surgical oncologist, is spearheading the drive for this new cancer center. Dr. Rutstein joined Central Maine Healthcare in Lewiston in early 2018, bringing more than 15 years of experience with a chief area of interest in the treatment of stomach, intestinal, gallbladder, pancreas and liver cancers, as well as breast and skin malignancy. 

The cancer center will be located on Main Street, Lewiston, at the main entrance to the CMMC complex. It will have multi-disciplinary clinics for cancer, according to Dr. Rutstein.

In the middle and northern parts of Maine, there has not been a lot of development of the surgical subspecialties of oncology, Dr. Rutstein said, noting that CMMC has been hiring doctors from throughout Maine and elsewhere that are trained in oncology. Dr. Rutstein does surgical oncology and works often with Dr. McGarr on upper GI tract issues, along with liver and pancreatic diseases, she said. CMMC has recently brought on a new ob-gyn surgeon, a colorectal surgeon, and a neurologic-oncologic surgeon.  

“The idea of the new building is that we can all be practicing together. So, if I’m seeing someone with pancreas cancer, (Dr. McGarr) can come in,” and meet the patient to do all the diagnostics, she said. “And then we have everybody in the same place and can see the patient at the same time. The advantage of that is, number one, it cuts down on the number of times the patient has to travel, and number two, it is efficient and cost-effective care because you are only charging the patient for one facility fee.”

Among the doctors who will be at the new cancer center are Dr. Nicholette L. Erickson, and Dr. Daniel C. Rausch, both hematology-oncology specialists, and Dr. Hector M. Tarraza, an ob-gyn specialist who is the new chief of the oncology institute at Central Maine Healthcare. 

Having the cancer center in Lewiston means patients in northern and central Maine needing ob-gyn oncology care won’t have to travel three or four hours to find care in the southern part of the state, Dr. Rutstein said, and they will have coordinated care closer to their homes.

Dr. McGarr said it’s important for patients to be able to get care without having to travel from town to town to see doctors as needed. CMMC is building a network of providers and facilities that will provide patients and their primary care providers (PCP) with easy access to care and follow-up for cancer treatment, he said.

Dr. Rutstein said that when she first arrived at CMMC, she created an oncology center to provide patients and doctors with a single phone number to call if they have a concern about cancer, a diagnosis of cancer, or a recurrence of cancer. The doctor can say, “I think my patient has cancer,” and can call that central number. At that point, the patient is entered into the system, is assigned a personal assistant to help them navigate through the process of care, and then the oncology team determines what the patient needs. “And that’s the goal, rather than this fragmented approach, which is so frustrating for doctors.”

The cancer center, or institute, will be where “we will see, manage, (and) treat people with cancer,” Dr. Rutstein said. The Dempsey Center will provide the social care and holistic support around the institute. 

In Maine, cancer services have mainly been developed in the southern part of the state, but looking at the prevalence of cancer in Maine, “it’s in the middle and northern part of the state,” Dr. Rutstein said. It can be hard for patients to reach existing services in the southern area of the state, she said.

There is now a strong surgical leader for Maine in Dr. Scott R. Johnson, who understands how to provide regional care to patients in an effective manner, Dr. Rutstein said. Johnson is a 20-year liver transplant surgeon who was a program director at Beth Israel. He “works with everybody, without bias,” and has recruited a number of excellent doctors to the CMMC team, she said.

Dr. Johnson is “very much in favor of working with everybody” in rural Maine, Dr. Rutstein said, and is now working with a lot of strong private groups in the state. “We’re developing health programs with them, and that’s under (Dr. Johnson’s) leadership.” 

CMMC has a philosophy of working with everyone in Maine, Dr. McGarr said, which provides better and more sensible care for patients, since they can continue to get care at a smaller local hospital near them. 

“The most important part of that relationship” between CMMC and other medical practices and hospitals “is making sure that their patient care is integrated with” that of CMMC, Dr. Rutstein said. The willingness to partner with other practices and doctors is key to a positive and successful experience for the patient. Other hospitals and doctors will be integrated “virtually” with the CMMC system to share patient information and treatment plans.